health systems, monitoring, evaluation, learning.

you’re not helping: seriously, CIA, we have enough problems convincing people to get vaccines, polio and otherwise

“At the behest of CIA officials, Afridi reportedly launched a fake polio vaccination campaign in Abbottabad last year, using it as a front to gather DNA samples from people thought to be relatives of the elusive Osama Bin Laden. This elaborate scheme would later contribute to the frenetic manhunt for and subsequent assassination of the Al Qaeda leader.

“(Before this) happened, one could brush aside negative perceptions about the polio vaccine, terming them baseless and ‘agenda-driven’, but not this time,” Fazal Shah, a development sector professional based in the northern district of Mardan, told IPS.

Religious leaders and tribal elders who had hitherto been highly successful in generating public support for the polio vaccine – by breaking myths about the vaccine being life-threatening, made of haram (forbidden) ingredients or causing infertility among both male and female recipients – found their efforts seriously hampered by Afridi’s hoax vaccination drive.”

“The CIA’s use of the cover of humanitarian activity for this purpose casts doubt on the intentions and integrity of all humanitarian actors in Pakistan, thereby undermining the international humanitarian community’s efforts to eradicate polio, provide critical health services, and extend life-saving assistance during times of crisis like the floods seen in Pakistan over the last two years,” the InterAction coalition wrote to the CIA director, David Petraeus.

“News reports out of Pakistan on the polio efforts there vary wildly, saying two very different things. Some say the efforts to vaccinate against polio are moving forward despite opposition from the Islamists, and from locals still mistrustful of health workers thanks to an ill-conceived fake vaccine ploy by the CIA… This report seems to indicate things are actually getting worse.”

“Yesterday, a male polio worker was fatally shot, and today four women were killed within about 20 minutes of each other in three apparently coordinated attacks in poor Karachi neighborhoods, including Gadap, where the July shootings occurred. Another woman was killed in Peshawar. Taliban insurgents have repeatedly threatened campaign workers, but so far no one has claimed responsibility for the current or previous attacks.”

“Pakistan now has a three-fold responsibility: addressing systemic polio eradication impediments, getting vaccination back on track with appropriate security cover for more 90,000 vaccinators, and reaching out to the masses with the right information to ally mistrust. At a minimum this would demand the will to prioritize action, the intent and ability of political factions to work collaboratively, and the ongoing injection of resources. With parliamentary elections forthcoming, all these will be in short supply.”

This situation unfortunately follows allegations that US security agencies used a Hepatitis B vaccination campaign as a vehicle for intelligence gathering (see here). And it is clear that such allegations have had a chilling effect on vaccination programs—for example in Nigeria (see here)–even when completely baseless.

Given that, it is in our own interest to make crystal clear that the US supports global public health programs to improve global health alone and that US-backed public health interventions will not be used to gather intelligence. While far from a panacea, it might help persuade a few more parents to get their kids vaccinated, or a few more local leaders to back down from a boycott. In the battle against global communicable diseases like polio and measles, every little bit helps.

Worldwide, the polio campaign depends on the efforts of volunteer and low-paid vaccinators who work solo or in small teams, and there are signs that the Taliban intimidation has kept those teams at home. In Pakistan, both The News and The Frontier Post are reporting that “lady health workers” are staying home out of fear or as a result of family pressure… The crisis in Pakistan is not just about the changeable fortunes of the polio campaign, which has waxed and waned in public opinion since its launch in 1988. It is specifically in response to the admitted-to ruse by the CIA